There was always a certain amount of ribald humour in the surgeons lounge and in the surgical change room in the olden days. Humour is a useful relief valve ; relieves tension and stress and and keeps us human.
      Dr. B was an oldtime general surgeon in the 60's when I first started orthopedics in the hospital. He was famous for his surgical skills and  equally so for his long penis. It was a source of conjecture and admiration amongst us. The more envious among us suggested it might be an optical illusion from unusually short femurs which allowed it to be lower to knee level than usual.
        When he operated in those years he always wore a very identifiable set of white surgical rubber boots. None of us ever wore such boots so they were unique.  Someone:  no one knows who. put his boots neatly together in front of  one of the toilets  enclosed behind a swinging door.  If in the process of changing for a surgical case or after a shower following a case, if two of our colleagues were gossiping with one another it was customary to look under the swinging door to ensure privacy and avoid offending anyone.
          Dr. B's boots sat neatly in front of the toilet for several hours, casually checked under the door by successive surgeons until one who had looked there much earlier as well, panicked and hollered , "Call the Arrest team"  just before he swung the door open to find nothing but the pair of empty boots. It was too late to cancel the bolting of the arrest team to the change room.  That was not such a misapprehension as one might think since many abrupt and sudden deaths occur with sitting and straining on the throne, especially embolism related.
         The arrest team called for naught. Dr. B , another legend added, and long gone from the change room. His presence on the John another optical illusion.

Trust the Medical profession to call the Obituary record of dead physicians as "necrology" ! Necrology is the study of dead tissue. In the case of the body it would be how the "remains" are described in organic terms;  or were, in the BC Medical Journal. Am I the only reader taken aback by such an overt description of our colleagues ?
       I guess it's reality, but you know, remains is a word that suggests that the necrotic tissue is just what is left. The remainder!  That implies there was something else.  What went ? The Vital Force!  Thousands of touchings;  millions of seeings and hearings; loving's and memories in abundance ; duties galore; and connectedness to the universe of ideas. The Journal came out the  day before I wrote this long ago and I knew 10 of the 20 obituaries that were listed from our province. Some of us check the obituaries more frequently than others in order to stay in the loop!
         It is not a contest to see who is going to live the longest, but to acknowledge and honour that passage of  John, " That when you are old you will stretch out your hands and someone else will dress you and lead you where you do not want to go. "---(John 21: 18 } That was not just Simon Peter's future, but the case for most of us as well!
          The careful ones who get to a ripe old age, may go like Oliver Wendell Holmes epic,  "The Wonderful
One Hoss Shay".  It remained in perfect shape for 100 years and then fell apart all at once.
          Or, if we are still well enough to plead for more time we may act like blind Teresies  (The Teresies from "O Brother Where Art Thou" , not Teresies the Mycenean Greek.} singing on the pump jigger on the track,  " Oh Death, Oh Death, won't you spare me over for another year? "
         Apostle, Physician, or Seer,  better be prepared. Those of us who practiced medicine for many years may have fought against it but we accepted death as the norm in both our patients and ourselves.
       Most people  prepare for a new birth with all the paraphernalia for the newborn well in advance not knowing the time of arrival, but wanting to be ready.  There can't be anything more important than the passage into a new life and the preparation of the family for the new Vital Force. The passage of the old life to "God knows where" has the same immensity. Why then do so many of us fail to get ready in the same way and instead operate by denial.
          I guess like Simon Peter we probably don't want to be led where we do not want to go. Like Teresies we hope to defer for another year. Some hope, like The One Hoss Shay to remain in perfect shape for 100 years and clutch a letter from the Queen.
           I'm afraid necrology is too much Pathology for me and not enough heart. Remains.  to me,  concludes that there is something else. Something incorruptible : the Vital Force
        

I worked for a man for a period of time, fortunately brief, who referred to himself as, " One " !  Not "I" or "Me" or even the royal "We" , but solely and deliberately  " One ".  As in ,  "One thinks this"  or,  "One should do this"  or  " One has no patience with " .  At least it would be clear recognition that he was speaking  more about himself than the subject he thought he was talking about, if he started with,  ' I "  or  " for  Me ".  At least that rings with more modesty and less narcissism ! The pronouns we use may be a marker revealing our inner selves.  It occurred to me at that time that we could classify people in one form of measure as those wanting to please and those wanting to be pleased.  It's not that he was difficult to work with because he wasn't.  He just saw himself as not one of   "the little people ".
          I am occasionally astounded at the boundless confidence of those who are in command. Seemingly what is good for General Bullmoose is good for the country.  Wanting to please may be seen as  " toadying " by some, or reflective to getting ahead by any means or at all cost  by others, but that  fails to account for the old adage that  " he who would lead must first learn to serve. "  That does not mean I cast off all my boundaries.  It just means a lot more hard work. It also demands intuition.
          The lofty out look of  " One ",  who unfortunately saw himself as exercising   " noblesse oblige "  at every opportunity,  revealed in fact that he was a social innocent.  Needing to be pleased may be a precarious and fragile walk of life. The hounds will be at your heels;  and I am.  " Uneasy lies the head that wears the crown. "

 Some years ago a male patient in his forties came to the office with a hard swelling in his left buttock. He stated that it had been present for several years but had become larger over the latter few months and was becoming more and more painful and uncomfortable to sit. My examination revealed a hard, tender, localized swelling over the ischial tuberosity;  the bony prominence that bears the seated weight in the normal buttock.  It was palpably much more prominent on the left side than the tuberosity on the right buttock.
      The history the man provided initially was vague and seemed evasive, or at least uncertain. He had never seen a doctor about the complaint until his general practitioner referred him to me. I subsequently obtained an xray of his pelvis which showed a 22 bullet within the left ischial tuberosity and surrounded by an expanded bony cyst which was  reactive. It was apparent that the history required more disclosure.
       The patient confided that he had been surreptitiously visiting the wife of a man who  suspected her of a sexual liaison. The irate husband waited for proof and received it when he opened the bedroom door with a loaded 22 rifle in hand. My patient was frantically clearing out of the bedroom window when he received the gunshot wound in his left buttock.
           This patient was fortunate on several counts. The offended male never saw his face and couldn't describe any other identifying features on his buttocks. He was shot with merely a 22 and so was on the fuel of adrenaline, able to run, hide and avoid a hospital or clinic. The bullet remained intraosseus because of its low velocity and the high resistance of the bone. Because of that it did not stray into bowel or bladder where much damage would have ensued.
             This subsequent surgical operation is always called, "removal foreign body" . I practiced a busy orthopedic practice from !963 to 2001. That is the only gunshot case I ever had in a practice in Canada that included at least 600 surgical operations a year. That would include self afflicted injuries. Imagine that in contrast to our unfortunate neighbour to the South with the second amendment  alive and well  and others not  !

Gunnara has no relation to dinosaurs or rhubarb. At mid-summer time my patch was ten feet tall with 4foot wide leaves and the patch 40 feet wide and growing. The leaf covering you see will compost down over the winter  and the wonderful shoots will push the compost aside and emerge in three weeks in the early spring as shown. It has been in this spot for twenty years. I had it in another spot for eight years and needed an excavator to transplant the root balls to this site.
       I think really anyone who grows a plant like this is marginally crazy. But it is monumental as the second view shows in late summer. In the fall Gunnera is attacked by the deer that are in rut since the stems have large spikes that remove antler velvet rather easily so that the bucks can be more fierce. By fall the Gunnera is rapidly declining for the year and will need the three feet of leaf compost for the winter.
       The plant as you can see is large, coarse, spectacular, tropical and in your face. It's probably a man's plant.

I was 14 years old and we were playing baseball at Porcupine Plain Saskatchewan. Our team was from Prairie River. It was a practise before the game started. As we were shagging fly balls, I was doing the hitting out at home plate. My attention was diverted for a moment by something or other and when the fielder who caught the fly ball threw in from left field it conked me on the head. I fell to the ground and had a momentary loss of consciousness. My dad came over to me as I was groggily waking up.
    He said,  "Always keep your eye on the ball."  I tucked that in my memory. Good advice even though I was still on the ground. " Keep your eye on the ball"  has to do with focus.  It's not exactly the same as " always keep your stick on the ice"  which is called readiness. It's the fellow-traveler to focus,  It's maintaining a state of readiness. You won't fluff a pass and a shot because your stick is in the air and you're skating like an idiot.
      Life is so fragmented these days that we have a hard time to achieve this effective state. You can only do one thing well at one time if you are anything like me. It's easy to be distracted. If one is easily distracted on the ball diamond, particularly if you are pitching, you are known as  "rabbit  ears". The catcalls from the bleachers and the other bench will be relentless. Fuggedaboudit!
      I'm not going to get conked on the head again. I'm going to keep my eye on the ball. And I'm  going to get the puck and shoot because I'm ready and my stick is on the ice.
    
    

I have a recurrent dream that I have had for most of my adult life. I think there are significant dreams and there are idle dreams that one can enjoy and then ignore.  The recurrent dream that is mine is that I am in my under shorts,  in an  urban setting in a crowd of people where I am trying to hide and also trying to find more clothing. The people observe me but make no comment and don't seem interested. I do not recognize any of the people in my dream. They are generic. I feel exposed and embarrassed in the dream and have a sense of urgency to find my clothing.
        In the dream of course there is no resolution of my problem because the resolution of the awkward recurrent dream comes from the outside rather than inside the dream. As a result I never find my clothing and the dream fades.
          Clothing can be both a cloak or a statement. It may be both,  setting aside the obvious like not freezing to death or toiling in the soil in the burning sun.  Whether a cloak or a statement the individual himself will have to supply the answer. One's inner and one's outer man are hand in hand. Leonard's song about  "My Secret Life" is a touchstone. One can fool most of the people most of the time but you can't fool the inner man. I don't pretend to be an expert on Jungian ideas, but he was always clear that aside from the principles of interpretation, the ultimate testing comes from the individual whose dream experience it was.
           I think in my case I took the boy out of the country, but I couldn't take the country out of the boy.
     
         

In the 60's, fondue was all the rage, at least in our neck of the woods.  Slow eating was in.  Cool folks huddled around  hot cooking oil in a communal pot on the dining room table.  Little cubes of beef sizzling on a sharp fondue fork,  frequently falling off the fork into the pot;  some-time chefs fumbling around with their fork, poking to find their cubes and knocking off everyone else's meat in the process.  In time some skill was acquired but the greasy cube was carefully  hauled across the table avoiding  dripping on the table or everyone else and dipped in creamy dill or plum sauce. Clearly I was not fond of fondue but others were and the pianist also pursued chocolate fondue with fresh strawberries and  cheese fondue with bread cubes.
       For those who enjoy a languid, more cognitive eating style, it could be a conversational bonanza so while your little cube is cooking, your mouth empty and working overtime talking, despite the constant attention to keeping the oil boiling, the meat from being overdone, the gymnastics with the forks at the minimum, plus  deciding whose fork is whose. To achieve that languid space you just had to decide to eat less. Fondue is not a guy thing. Crude  as it may seem I was always driven more by my hypothalamus and parotid gland to fill up,  so mercifully for me,  fondue has succumbed to time and the rat race.
       The Garden at Lotus Island always had a few artichokes.  They are beautiful when growing and in flower.
Eating the chokes is in addition to fondue another contribution to the Slow Loris eating industry. Sucking and scraping away at the sepals of the flower bud after dipping in garlic butter the eater will need to recondition himself to get rid of the grease and fuzz. Dipping the soft and tasteless bases of the calyx requires preemptive action of slow dissection, ridding oneself of the  nascent fuzzy petals which guarantees that the rest of your meal will get cold while filling the garbage pail with the 90% that is the inedible part of the choke. My advice to artichoke lovers is let them flower into their magnificent purple thistle like head and have a table centre for them  with your meat and potatoes and ketchup.  Quelle delicatesse!

      In Anthony Trollope's fiction  Barchester Towers his character Mr. Arabin says to Eleanor Bold,  "I can become equally convinced of the logic of completely opposite points of view."  Another inconsistency would be the  assertion that one " always believes the last thing he was told or heard."  Myself on the other hand has in some ways envied those who have strong and lasting points of view,  though possibly they fall into the category of  " frequently wrong but never in doubt".
        I remember when my turn as Chief of the Medical Staff at the Royal Jubilee Hospital began, my predecessor saying to me,  "You're going to have trouble with this job unless you get rid of your naivety.  There is a difference between being open-minded and having " holes in your head" .  I told her I thought my ability to see all points of view gave me the opportunity to mediate, a valuable resource as Chief. She said that argument, is often marshaled in a facile  way by the dogmatic and manipulative, that can beguile the open minded. 
         As we talked of decision making and points of view I thought of Mr Arabin and Eleanor Bold. If one hears reasoned argument for opposing points of view  and does not have time for the logic, then put it on the shelf till you do. There is nothing like time to resolve issues and the urgency is rarely ours. Where urgency exists, Eleanor's observation to Arabin was apt to me as well. She believed he had strong points of view which he was unwilling to reveal. She had to give him a nudge but he loved her and she knew it. Those who care for you will always tell you their truth about yourself.  Though my relationship with my predessor was that of stewardship of the hospital rather than love, I valued her opinion, but like Arabin tried to soften strong points of view, for unity ! 
       

I was testifying in the Supreme Court as an expert witness on behalf of an insurance company in an accident claim. The previous day my esteemed colleague had testified for the plaintive.  This was a jury trial.  The plaintiffs lawyer was challenging my written report that had been earlier submitted to the court. My opinion differed from my colleague's opinion that had been rendered the previous day.
        I was sitting in the witness box, still under cross-examination, when the judge made an observation to the jury.  He said, as nearly as I can remember,  "You the jury, have heard two distinguished physicians arrive at different conclusions based on consideration of the same set of facts. This reminds me, "he said, " of old judge So and So, QC who defined an expert witness as a sonofabitch with a briefcase."  I was speechless. So were the lawyers. There was a long pause as the jury members looked at one another and inwardly digested the lord's remark. After the fact, I thought of many clever things I might have said, but the judge is Master of the Court and contempt towards it is not easily undone.
        To anaiyze, we often place a jury in a difficult situation when evidence of both witnesses may be equally persuasive. Medicine in many instances is  not an exact science. As you may expect this observation swung the scale and the plaintiff received a large settlement. The defense had the basis for appeal on possible grounds of judicial bias but did not do so.
        In retrospect the judge may have been expressing a frustration many judges and juries do have and that is having to choose between testimony they believe is conditioned by   "who pays the piper calls the tune". In fact, having reviewed many such scenario's the truth that is much more usual is  "the payer {lawyer} shops for those pipers{doctors} whose tune he knows he can dance to." Judges should know this of course since lawyers judge shop as well as witnesses. It's a question of shopping, not collusion and is not really mystifying.